H.R. 1 Reconciliation Legislation Summary: Key Provisions for Children’s Health and Hospitals

This summary outlines the key provisions within the H.R. 1 reconciliation legislation that are relevant for children’s health and hospitals.
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On July 4, 2025, President Trump signed the budget reconciliation bill, H.R. 1, into law. The law makes significant changes to the Medicaid program. In particular, the law more strictly limits use of provider taxes and state directed payments, constraining the ways states can raise revenue to finance their share of their Medicaid programs, among other cuts to Medicaid. Other provisions make changes regarding the Marketplace, Medicare, and immigrant access to federal health programs.

The attached summary outlines the provisions within the law that are most relevant to children and children’s hospitals.

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